Judge blocks key ACA marketplace rule provisions for 2027
For the second consecutive year, a federal judge has provided relief to plaintiffs challenging Trump administration regulations that are intended to tighten limits on Affordable Care Act (ACA) marketplace coverage. A July 16 ruling by Judge Brendan Hurson with the U.S. District Court for Maryland halted implementation of key provisions in recently finalized regulations that…
Comparison of Proposed 2027 ASC Addendum BB to 2026 Addendum BB
This spreadsheet compares ASC covered ancillary services integral to covered surgical procedures, using 2027 proposed rule Addendum BB compared to 2026 Addendum BB.
Comparison of Proposed 2027 ASC Addendum AA to 2026 Addendum AA
This spreadsheet compares relative weights and payment rates for ASC covered surgical procedures at the HCPCS level, using the 2027 proposed rule Addendum AA compared to 2026 Addendum AA.
2027 Medicare Physician Fee Schedule proposed rule includes broad payment changes
Physicians will incur a payment decrease in 2027 unless Congress intervenes, according to a CMS proposed rule issued July 14 for the Medicare Physician Fee Schedule. Statutory provisions call for increases of 0.75% for clinicians participating in advanced alternative payment models (APMs) and 0.25% for nonparticipants. However, those raises and a 0.53% bump stemming from…
CY 2027 OPPS/ASC Proposed Rule Summary
HFMA presents a detailed summary of the proposed rule published by CMS on July 7, 2026, updating OPPS payment policies that apply to outpatient services provided to Medicare beneficiaries.
Medicare skin substitute reimbursement changes have raised provider risks
A formerly high-revenue healthcare service has been diminished on several fronts in 2026. Medicare Part B spending on skin substitutes increased by 640% between 2022 and 2024, reaching nearly $3 billion per quarter, according to a government report. Steps taken by CMS and policymakers to counter that trend include an overhauled payment system and an…
Cost saving strategies, a more modern patient experience and more
Nick Hut discusses the Medicare OPPS Proposed Rule with Kathy Stull. Erika Grotto talks with Michael Driscoll of Fidelity Investments about cost saving strategies for employers and with Tracy Monson from Onbe about modernizing the patient financial experience.
OMB grant rule raises compliance questions for hospital federal funding
Hospitals that receive federal grants are among the entities that would face new requirements under a Trump administration proposed rule. The Office of Management and Budget (OMB) issued the rule, which would increase federal oversight of how grantees apply for and use funds. The intent is for the rule to take effect Oct. 1, covering…
CY 2027 Home Health Prospective Payment System Proposed Rule Summary
HFMA presents a detailed summary of the proposed rule that would update the payment rates for home health agencies for calendar year 2027.
MedPAC sees no broad Medicare Advantage hit to hospital finances
Recent growth in Medicare Advantage (MA) enrollment is not associated with an adverse impact on the finances of hospitals and post-acute care providers, based on findings of an observational study by the Medicare Payment Advisory Commission (MedPAC). However, the shift of beneficiaries from traditional Medicare to MA is affecting providers operationally and could be skewing…